Elizabeth Cooley Annamraju, L.M.F.T.
Individual provider Active NPI Marriage & Family Therapist · Diamond Bar, CA
NPI 1346601663 · NPPES record last updated Mar 14, 2016
Key facts
- NPI
- 1346601663
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- MFC32107 (CA)
- Practice address
- 22752 White Fir LN
Diamond Bar, CA 91765-2541 - Phone
- (909) 576-5970
- NPI assigned
- Mar 14, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Marriage and Family Therapist
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Soultenders Inc
Practice addresses (Care Compare)
250 W 1St St
Suite 346
Claremont, CA 91711-4742
Phone (909) 343-4550
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240301002222 | CA | Practitioner - Marriage and Family Therapist | 6800231713 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFC32107 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Soultenders, Inc. | Current |
Accepting new patients | |
| Soultenders Psychological Services, Inc. | Current |
Accepting new patients |
Locations
41 E Foothill Blvd
Ste 102
Arcadia, CA 91006
Phone (626) 701-4249
250 W 1st St
Ste 346
Claremont, CA 91711
Phone (909) 343-4550
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFC32107 | CA | Yes |
Addresses
Primary practice location
22752 White Fir LN
Diamond Bar, CA 91765-2541
Mailing address
22752 White Fir LN
Diamond Bar, CA 91765-2541
Phone (909) 576-5970
Other names
- Elizabeth Maria Cooley
Other providers in Diamond Bar, CA
- Angeles del Sol Adhc, LLC
- Angeles del Sol Adhc, LLC
- Angeles del Sol Calaim LLC
- Angeles del Sol Cbas
- Jovel Hernandez Angeles
- Annie Aharon Annapogu
- Anvea Health Inc
- Maria Rebecca Orsolino Arambulo
- Tanzim S Arastu
- Lorindha F Argudo
All providers in Diamond Bar, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 14, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.